A report published in the Official Journal of the American Academy of Pediatrics has mostly good advice for parents but questionable data about 'Facebook depression.'
American Academy of Pediatrics

With the exception of the section on "Facebook depression," a report released Monday by the American Academy of Pediatrics has some excellent advice for parents of social media users.

Clinical Report: The Impact of Social Media on Children (PDF) starts out with data showing that teen and pre-teen use of social media has "increased dramatically" over the last five years, as has use of cell phones and texting. It also points out that "because of their limited capacity for self-regulation and susceptibility to peer pressure, children and adolescents are at some risk as they navigate and experiment with social media."

The report goes on to list some of the many benefits of social media for children and adolescents including opportunities for community engagement, enhancement of creativity, growth of ideas, expansion of connectivity and shared interests, and "fostering of one's individual identity and unique social skills." It also talks about how social media can enhance learning opportunities and that "adolescents are finding that they can access online information about their health concerns easily and anonymously."

Risks
The list of risks summarized by the report also appears pretty spot on: cyberbullying and online harassment, privacy concerns, and "influence of advertisements on buying." It offers pretty sound advice about sexting, although it cites a study that is old and considered by some to be inaccurate. The report's statement that "a recent survey revealed that 20 percent of teens have sent or posted nude or semi-nude photographs and videos of themselves" is based on the not-so-recent 2009 report from the National Campaign to Prevent Teen and Unwanted Pregnancy Sex and Tech: Results from a Survey of Teens and Young Adults (PDF). A more recent report from the Pew Internet & American Life Project "found that 4 percent of cell-owning teens ages 12 to 17 say they have sent sexually suggestive nude or nearly nude images or videos of themselves to someone else via text messaging." That Pew study also reports that 15 percent "say they have received such images of someone they know via text message."

Facebook depression?
But despite all of the positive things in this report, the section that's getting the most media coverage is the one that says "researchers have proposed a new phenomenon called 'Facebook depression,' defined as depression that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression." It further says that "the intensity of the online world is thought to be a factor that may trigger depression in some adolescents" and concludes "as with offline depression, pre-adolescents and adolescents who suffer from Facebook depression are at risk for social isolation and sometimes turn to risky Internet sites and blogs for 'help' that may promote substance abuse, unsafe sexual practices, or aggressive or self-destructive behaviors."

Co-author provides perspective
After looking at all the references in the report that were accessible for free online, I still couldn't find any scientific evidence that Facebook leads to depression. I called the report's co-author, Dr. Gwenn Schurgin O'Keeffe, (scroll down to listen to podcast) to seek clarification on that point. She mentioned a report from Stony Brook University that, according to O'Keeffe "showed that kids who were spending time with online sites such as instant messaging and chatting...had a more profound emotional reaction when they had anxiety and depression." But, as I'll cover later, that study's lead author told me that her paper "doesn't have anything to do with Facebook depression."

In the interview, O'Keeffe stressed that "Facebook depression is very well framed as a new and evolving situation that affects a small group of kids (emphasis added). She said that "Facebook is really a magnifier. You're not going to catch something on Facebook, but Facebook tends to amplify any of our insecurities or anything we're feeling good about." She said that "it appears that it's the kids who are already heading toward true clinical depression that have the Facebook depression situation. It's not the normal kid who's going to have clinical depression occur because of Facebook."

After speaking with O'Keeffe, it seem to me that the diagnosis of "Facebook depression" is somewhat tentative and that media attention to that one aspect of the story may have been overblown. "Maybe we're misnaming it," she said. "We only go by the best information we have today."

Researcher says no Facebook depression evidence
One of the studies cited by the report and mentioned by O'Keeffe at the start of our interview is "Romantic and sexual activities, parent-adolescent stress, and depressive symptom among early adolescent girls." But in a podcast interview (scroll down to listen), that study's lead author, Professor Joanne Davilla of Stony Brook University, said her paper has nothing to do with Facebook depression. "That paper looks at whether depression in adolescents predicts risky sexual activity and risky romantic relationships...but that's a completely different topic." She added that "my lab and I have not published any data on Facebook and depression." She says that they have data currently under review "that will speak to the issue but I have not published a paper demonstrating any relationship between Facebook and depression." She said the work she has done has been "completely mis-cited by the media and by other people who have talked about it which is very unfortunate."

Davilla said she has recently conducted two as-yet-unpublished studies on 600 undergraduates "that actually looks at use of social networking and quality of social networking-interactions and depressive symptoms and what we find is that just the use of social network--how frequently people engage in using Facebook for example--is not associated with depressive systems." She said that "the quality of the interactions that people have with others" is associated with depression. "When people have more negative interactions with people they're interacting with online, they're more likely to have a depressed mood and depressive systems. She agreed that this would likely be the case regardless of where the negative interaction took place.

"Social networking is just another salient venue where problematic relationships can play out and have an impact on depression," she said, adding that there might be unique aspects to Facebook that affect emotional reactions but "we haven't studied them yet." And then she re-emphasized, "If there is one message I can get across is that we don't have solid scientific evidence that there is some unique thing called Facebook depression. We do know that when people have problematic interactions online, on Facebook, that is related to depression.

More conflicting evidence
An abstract for another reference cited in the report,"Different types of Internet use, depression, and social anxiety: The role of perceived friendship quality," reported: "For the adolescents who perceived their friendship quality as low, the time spent instant messaging predicted less depression and the time spent in surfing predicted more depression and social anxiety. For other adolescents, no such association was found."

One of the report's references cited a 2009 blog post on ReadWriteWeb entitled "New illness: Facebook depression," which concluded, "The headline 'Facebook Depression' is meant to be a little tongue-in-cheek and it should not be taken literally to mean that using Facebook causes depression."

Another AAP reference was to an article in the Truman State University Index, written by a freshman linguistics major who points out that even connected people can be lonely and that "Research shows that this loneliness can result in depression, and on the Truman Web site, it stated that 18.2 percent of Truman students are depressed. This number doesn't seem that large, but look through your friend list on Facebook. Out of every 100 friends you have, 18 to 19 of them probably are depressed." In other words, some students are lonely and get depressed and depressed students use Facebook.

Cornell study on Facebook and self-esteemOne very recent study that the AAP didn't cite, came from researchers at Cornell who found that Facebook can enhance self-esteem. In a Cornell press release about the study (which was published in the peer-reviewed journal Cyberpsychology, Behavior and Social Networking), co-author, associate Professor Jeffrey Hancock, said "users can choose what they reveal about themselves and filter anything that might reflect badly. Feedback from friends posted publicly on Facebook profiles also tends to be overwhelmingly positive, which can further boost self-esteem." Hancock added, "for many people, there's an automatic assumption that the Internet is bad. This is one of the first studies to show that there's a psychological benefit of Facebook."

Dr. John Grohol, editor-in-chief of PsychCentral.com, wrote a very critical analysis of the AAP report, saying that authors "can't differentiate between correlation and causation." Calling the report "shoddy research," he claims that the authors "ignore research that disagrees with their bias" pointing to studies that show that for college students, "Internet use was directly and indirectly related to less depression." Grohol, said that none of the research studies cited by the AAP "could demonstrate a causative relationship between use of Facebook making a teenager or child feel more depressed." O'Keeffe said that a response to that editorial is forthcoming.

Clearly, there are people who use Facebook who are depressed but what isn't clear is whether Facebook users are any more likely to be depressed than non-Facebook users and, even if that's the case, whether that's because Facebook causes depression or because depressed people are more likely to turn to Facebook to help them deal with their depression. I haven't done the research, but I'm pretty sure that children who visit pediatricians (except for regular checkups) are more likely to be sick than children who don't visit them. Does that imply that pediatricians cause illness? Of course not. As Grohol pointed out, a correlation does not necessarily mean causation.